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General NPI Number Information
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NPI Number | 1376905026
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Entity Type | Organization
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Legal Business Name | SOUTH ORANGE COUNTY COMMUNITY COLLEGE DISTRICT
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 01/22/2021
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Provider Practice Location Address
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Address Line | 28000 MARGUERITE PKWY
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City | MISSION VIEJO
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State | CA
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Zip | 92692-3635
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Country | US
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Telephone | 949-582-4606
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Fax | 949-582-4227
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Provider Business Mailing Address
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Address Line | 28000 MARGUERITE PKWY STUDENT HEALTH SERVICES - SSC 177
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City | MISSION VIEJO
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State | CA
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Zip | 92692-3635
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Country | US
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Telephone | 949-582-4606
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Fax | 949-582-4227
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Authorized Official
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Title or Position | DIRECTOR, STUDENT HEALTH SERVICES
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Name | DR. JEANNE HARRIS-CALDWELL
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Credential |
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Telephone | 949-582-4607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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